Objective To investigate the correlation between the tracheal transverse diameter's variation (ΔTD) during endotracheal tube (ETT) cuff inflation measured under ultrasound and the ETT cuff pressure (CPETT) and its guiding significance to ETT cuff inflation. Methods Male patients, received endotracheal intubation under general anesthesia from June 2020 to August 2021, aged 18-60 years, BMI 18-25 kg/m 2, ASA physical status Ⅰ- Ⅲ, were selected. This study was consisted of two sections. In the first section, 90 patients were enrolled. ETT cuff was inflated by palpation. The tracheal transverse diameter at the level of suprasternal fossa was measured under ultrasound before and after inflation. And ΔTD was calculated. Then the ETT cuff pressure (CPETT) was measured by a manometer. After that, the cut-off value of ΔTD was obtained by receiver operating characteristic (ROC) curve and its prediction efficiency was analyzed. In the second section, 46 patients were recruited and randomized into two groups according to the inflation method: the palpation group and the ultrasound group, with 23 patients in each. In the palpation group, the ETT cuff was inflated using palpation method. And in the ultrasound group, the cuff inflation was guided under ultrasound with the cut-off value of ΔTD. All of the CPETT were measured with a manometer after inflation. Results When the CPETT was within 110 cmH2O, the CPETT had a significantly positive linear correlation with ΔTD (r = 0.78, P < 0.05). The area under ROC curve (AUC) of ΔTD was 0.85. The cut-off value of ΔTD was 1.25 mm, with a sensitivity of 70.5%, and a specificity of 84.2%. Compared with the palpation group, the ratio of suitable CPETT in the ultrasound group was significantly increased (P < 0.05). And the ratio of excessive CPETT was significantly decreased (P < 0.05). Conclusion When the CPETT is within 110 cmH2O, it has a significantly positively linear correlation with ΔTD. Compared with the palpation method, the ΔTD measured under ultrasound can better guide the inflation of ETT cuff. |